By Petra Fibrichova 

Parkinson’s disease is a progressive neurodegenerative condition with a wide range of symptoms that can vary from person to person and day to day. Motor problems such as rigidity, slowness, postural instability, gait changes, and tremors define Parkinson’s, but other symptoms—anxiety, depression, apathy, cognitive decline, sleep issues, blood pressure fluctuations, voice weakness, and digestive or urinary challenges—often impact people just as much. Many see multiple specialists, leading to an ever-growing list of medications.

Augment management of Parkinson’s disease with yoga therapy

Yoga therapy offers a holistic approach, working with the entire person rather than just managing individual symptoms. Using the koshas, or sheaths of being, I guide clients in exploring how Parkinson’s affects them on multiple levels—physically, energetically, mentally, emotionally, and spiritually. Through gentle inquiry, people gain awareness of areas they may have overlooked, such as breath patterns, shifts in their emotions, and self-perception.

We address posture, balance, mobility, and strength while focusing on energy flow and mindfulness. For example, when asked to focus on extending their arms fully, I find that many clients create unnecessary tension in their face and shoulders and hold their breath. (Incomplete and small movement is a typical symptom of Parkinson’s.) We work on creating a balance between effort and ease (sthira and sukha) and maintaining a steady flow of breath while still aiming for a full range of motion.

The simplest movements sometimes become confusing, and shame often follows. So in my yoga therapy sessions we spend time talking about how Parkinson’s disease disrupts automated movement patterns, and we practice being compassionate and patient. This is crucial work, as Parkinson’s is a progressive disease and people do lose abilities over time. I often remind clients that when they struggle to figure out a movement, it means the brain is being challenged—a good thing and one of our purposes.

Help from yoga’s sister science of ayurveda

Ayurvedic principles, particularly doshas (constitutional types), can also be helpful. Some clients recognize how their competitive nature—possibly linked to what yoga therapists might refer to as a fiery pitta constitution—causes frustration when they compare themselves to others not affected by Parkinson’s or to their younger selves.

Others benefit from grounding techniques to balance the mobile, dry, rough, and cold qualities of vata dosha, which in my experience often manifest in this condition as anxiety, constipation, and difficulty focusing. These clients work on slowing down, creating consistent daily rhythms, and incorporating warm, nourishing meals with healthy fats. One busy client, for example, signed up for meal delivery to improve her diet and chose salads to incorporate more fiber. However, she started experiencing dry skin, and her constipation wasn’t getting better. We discussed that to pacify vata, eating warm meals with liquids and fats would be better. Fortunately, the delivery service offered warm options that still contained a lot of fiber but were more nourishing for her constitution. Her skin started to feel better after a couple of weeks of this new diet.

Sessions with me

Each yoga therapy session begins with a check-in, allowing clients to express how they’re feeling physically and emotionally. This is a moment of trust, and I strive to hold a compassionate space. Sometimes I offer helpful resources, but often simply listening is what matters most.

I tailor the session according to each person’s needs. Some days, we focus on physical movement, whereas other times we might emphasize nervous system regulation through restorative yoga. My sessions always conclude with simple pranayama (breathwork) and a guided body scan to promote healthy breath patterns, relaxation, and awareness.

Exercise is as vital as medication in managing Parkinson’s disease. As both a yoga therapist and personal trainer, I integrate yoga asana (postures), light weight training, balance exercises, and high-amplitude (mindfully exaggerated) movements to enhance mobility and strength and push back against the physical symptoms. Music often plays a role in my sessions, as it can improve rhythm and engagement, especially for clients experiencing cognitive challenges. For those with balance issues, weakness, or postural hypotension (low blood pressure), working in a chair provides a safe, effective alternative.

Many clients I’ve worked with, especially those with young-onset Parkinson’s, experience anxiety and shallow breathing. Their diagnosis disrupts work and personal life, creating uncertainty and stress. Our yoga therapy practices incorporate mindfulness, breath awareness, and guided relaxation to encourage diaphragmatic breathing and ease fear. Restorative moments such as supine relaxation with body scanning or seated meditation with uplifting mantras help people to reconnect with their essence, fostering self-compassion and acceptance.

Over the years, my work with many clients has shown just how valuable yoga therapy is as a complementary modality for supporting Parkinson’s disease. I have had the privilege of witnessing the profound impact of this practice as its introspective nature, adaptability, and holistic benefits make a meaningful difference in people’s lives.

Petra Fibrichova, C-IAYT, is a certified yoga therapist and personal trainer who teaches group classes and one-to-one sessions for people affected by Parkinson’s disease in the San Francisco Bay Area. She is passionate about empowering people to stay active and teaching simple yoga tools to improve well-being.